Despite its diminutive size, the Netherlands has historically carried a large weight in the world because of certain cultural endowments: small but united, entrepreneurial, innovative, and externally oriented. During the Dutch Golden Age, the "Low Country" monopolized international trade and commerce, giving rise to tulip manias, artistic masters, and the world's first multinational corporation. Though the sun has long set on that era, the historic imprint of the Netherlands' open mindedness to the world defines its present industrial standing. Today, the pharmaceutical industry looks to the Netherlands for a world-class medical infrastructure, new standards in innovation, and a closely-knit community of stakeholders. Like many countries, the Netherlands will need to adopt new approaches to tackle the increasing challenges of cost-containment pressures and fiscal austerity. But as history has proven, "going Dutch" has come to mean a proactive nature and ambitious attitude that makes no challenge too big.

SMALL IS BEAUTIFUL

At an initial glance the Netherlands might not seem like the most attractive of pharmaceutical markets. Sandwiched in between big brothers France, Germany, and the United Kingdom, a modest population of over 16.5 million Dutch inhabitants hardly drives global growth for multinationals. But it is precisely the assets derived from a small market, mixed with a unique Dutch identity, that makes the Netherlands an ideal destination for international commerce, pharmaceuticals included.

Minister Edith Schippers, the Netherlands Minister of Health

That the Netherlands is a country literally built on ingenuous innovation goes a long way in explaining the creative flair of the culture. Inhospitable below-sea-level conditions bred infrastructural novelties in the form of iconic windmills and Amsterdam's dizzying array of canals. Cooperation, collaboration, and coalition-building were essential for survival. Furthermore, the country's rich history as a trader nation engendered a sharp commercial instinct. Translated to today's pharmaceutical industry, ingenuity, collaboration, and commercial prowess are embodied in a "build, bundle, and benefit" approach—the three-pillar strategy of the Dutch life sciences and health sector to combine the country's strong research talents with commercial opportunities through public/private partnerships and various investment vehicles.

"We are very good at the way of doing research, clinical research predominantly," says Dr. Michel A. Dutrée, general manager of Nefarma, the leading association for research-based pharmaceutical companies in the Netherlands. "The Netherlands has invested heavily in clinical research infrastructure that is based in universities and the country's top hospitals. We have almost 28 top clinical hospitals whose excellent medical specialists provide valuable research for industry. Our research strength and good relationships with biotech firms and universities is a major reason why big and intermediate pharmaceutical companies are interested in the Netherlands."

Further underpinning the attractiveness of the Netherlands for pharmaceutical and life sciences companies is a strong pipeline of top-level talent. Dutch education levels are consistently ranked among the highest in the world. A 2007 Global Talent Index of the Economist Intelligence Unit placed the Netherlands third (after the US and Canada) in its ability to attract and promote talent. Similarly, in the 2008 Times Higher Education World University Rankings, 11 of the Netherlands' 12 universities ranked among the world's top 200.

Dr. Michel A. Dutrée, General Manager, Nefarma

As Dutrée explains, "In contrast to other European countries, we have a network of universities here. Rather than competing with each other, Dutch universities work together since, ultimately, they are all government financed. Private financing streams do exist for Dutch universities, but base funding all comes from the government. It is very easy for government and industry to work together in the Netherlands since we are such a small country. The collaboration between the two entities is very pleasing for government."

"A typical and more traditional Dutch strength that comes from being a small country is to be very internationally oriented with an inclination for going all over the world," assesses Jan Wisse, managing director of Niaba, a leading Dutch biotechnology association. Consistent with this trait, approximately 87 percent of Dutch over age 15 speak English, 65 percent speak German, and 25 percent speak French, according to the Ministry of Economic Affairs. Strength in small numbers, ingenuous innovation, and openness to the world have indeed branded the Netherlands as a gateway to Europe. Top 50-pharmaceutical companies such as Amgen and Genzyme have chosen the country as its headquarters for European activities.